DAO and Diet: Does One Work Without the Other?

The short answer is maybe. The options in order of efficacy: 1. DAO and diet combined, 2. Diet alone, 3. DAO alone. There’s a very good chance the enzyme won’t be effective unless you also restrict your diet.

For me, diamine oxidase (DAO) has been very helpful only in conjunction with a low-histamine diet. From my experience trying to reintroduce foods, I am now positive that DAO alone would have done nothing for me. My dietician confirmed that. On our last call, she said “Even with DAO, you just can’t eat foods that are high in histamine. You just can’t.” Don’t panic, she was talking about me specifically, not everyone, and I’m an extreme case. (The link above will take you to a comprehensive Q & A on histamine intolerance and DAO. This one takes you to everything I’ve written about DAO.)

I’ve heard of a few people benefiting from DAO alone, but almost everyone who finds relief is also on a low-histamine diet. I know it’s a downer. Restricted diets can be a burden, especially at the beginning. It should tell you something that despite being frustrated and annoyed with my diet, I’m still sticking to it. Having times without migraine is just too precious and that only happens for me on the diet and taking DAO.

A few readers have told me DAO has been a magic bullet for them, but most who try it without diet modifications have no success or inconsistent results. Even with the diet and DAO, you may not get relief. If histamine isn’t a major trigger that sets migraine off in your body or gives you headaches, avoiding histamine or taking an enzyme that processes it won’t be of any use. Unfortunately, there’s no blood test or other quick, definitive way to figure out if this is the case for you.

I wish DAO were an easy answer and that the supplement could take the place of a restricted diet. Unfortunately, that’s just not the case for most people. And, unfortunately, it may not work at all for you — that’s just the nature of headache and migraine treatments.

Looking to buy DAO? You can get Histamine Block and Histame from Amazon. (I’m an Amazon affiliate, so I’ll get a small portion of the sales if you purchase through one of those links. I have no relationship, financial or otherwise, with any company that manufactures or sells DAO.)

10 Responses to DAO and Diet: Does One Work Without the Other?

Thx for the update! I recently tried it & didn’t notice a difference. I just tried a GF diet for the 2nd time, but this time for longer (2mo vs 1mo). It didn’t ease symptoms at all. :(. I may try a low histamine diet in the future, but right now I’m dieted out. Enjoy your blog so much!

Thanks for the reminder, Kerrie.
I’ve found some help, sometimes, with the DAO, but I suspect I’m getting dietary sources of histamine (or tyramine, since I understand that uses the same enzyme system) that I’m not aware of. For example, today I had a big bowl of broccoli (with 1/4 cup of tomato sauce, no other ingredients) and had a whopper of a migraine start later, so I’m dosed up on meds now. Bummer, especially in that I was trying to be especially “healthy” in my choice of a meal.

After an internet search today, I see that a number of places list broccoli as high in tyramine?!
Although I realize everyone’s different, I’d be interested if you sometime post an update of the foods you are still able to eat. I read earlier that you are rotating your food groups.

Ann, the lists I have from dieticians and medical groups don’t list broccoli as high in tyramine, though tomato is definitely high in histamine. It could be that all my lists are wrong or that you just happen to react to broccoli, even if it isn’t high in potentially problematic substances. There are some foods on all the “safe” lists that I react to (and some on lots of lists that I don’t react to). I know it’s confusing and frustrating!

If you have a set of foods you know are NOT triggers for you, you can eat those for a couple days, then try broccoli with nothing else on it. I usually test foods late in the afternoon — late enough that my entire day won’t be spent with a migraine, but early enough that I can see a reaction before I go to bed. If you don’t react, do this same test at least a couple more times. If you do react, you may not want to test broccoli again. Know, though, that it might be a “false positive” — maybe broccoli is OK most of the time, but not when your other triggers are high (like it’s stormy or you’re not sleeping enough); or it’s OK but not in combination with other foods; or it’s only OK once a month; or it’s totally fine, but some other factor is messing with the results. If it’s a food you love or your diet is getting too restrictive, you may want to test a couple more times or if the reaction is too severe, you may just want to avoid it.

I hope that’s not too much information. Testing foods is not straight-forward, so I’m trying to give you as much information as possible. But, information overload can complicate things even more. My best suggestions are to try to isolate as many variables as possible when you test food and remember that no food is necessarily permanently out of your diet. Let me know if I can clarify anything.

Thanks for your website and all your hard work. I am so happy that you are making progress with your diagnosis of HIT and migraines. I just wanted to mention The Low Histamine Chef website. It has been a great resource for my histamine intolerance. Instead of a more restrictive diet it focuses on using foods to heal based on the bioflavonoids quercetin, luteolin & rutin and other antinflammatory properties. Dr. Theoharides M.D., PhD, out of Tufts University has done a lot of research on Mast cells and even has developed a supplement using these bioflavonoids that can be very helpful for some people. He is also a great resource on the web to google. For me a very slow easing into her diet and adding twin labs quercetin plus C (I take this for its mast cell stabilizing properties and there is some research supporting its benefit for preventing intestinal permeability also know as “leaky gut”) has been very beneficial as has the juicing for nutrition and decreasing histamine load on the system.

I also have two mutations of the DAO gene. One other thing that was very helpful that I did in working with my doctors is see what medications can suppress the DAO enzyme. I got off 2 of those daily migraine prophylactic medications and the difference has been only positive so far. Less chronic migraines, some days without the daily headache. Yay! It was tough getting off them but worth it. I would stress to anyone out there though, if this were something you were to think of doing, please do this with only thorough consideration and under the care of a good team. Our brains are very sensitive and need to be treated well but we need to always be our own advocate 🙂

Anyway Kerrie, I thank you for your amazing site and wish you only the best and if any of this is helpful to you or your readers, I am happy.

I’m tempted for the 1st time in a long time to try a restricted diet. I have a gazillion questions that will take research. Mostly about high histamine foods and what plant families they are in because that would affect what I plant in my garden. Looks like all nightshade plants are out, but what family is spinach in, why are red beans on the no list but most dry beans on the yes list, why do I find info on creating a DAO smoothy with pea shoots and yet peas are listed on the no list, etc. I don’t expect you to have any answers, I’m just rambling. 🙂

I did decide to give B2, riboflavin, a good try before trying the low histamine diet. I’ve read it can take B2 up to 3 months to take effect and I try not to try too many new things at once. Plus it will give me time to research my questions. Methyl B12 and methyl foliate have greatly increased my energy, although I’ve not noticed a change in the chronic headache. I’m currently obsessed with my methylation cycle and all the support it may need, and that has been helping with the depression.

This has been very helpful. My son has severe, chronic migraines and very much benefited from a low tyramine diet, which he’s been on for a year. It didn’t so much stop his migraines, but it did make him MUCH less foggy – his mind became clearer. He just started the DAO last week and immediately noticed that he was clearer still. Even now with a migraine (triggered by an irritated occipital nerve from physical therapy), he still feels much clearer. He has two types of migraines – occipital triggered by irritated spinal nerves and trigeminal, mostly triggered by weather, food, and acts of God. When he gets both at the same time, it induces a horrific migraine that lasts for days.

The physical therapy and chiropractor are helping tremendously with the occipital. The tyramine diet is helping with the trigeminal. The fact that the DAO is immediately helping makes his hopeful that it will lower his sensitivity to other triggers. Expanding that range of foods he can’t eat is painful though. It seems, however, that cutting out snacking may be really key. We always wondered why he didn’t get migraines at school but always got them on weekends and vacations – opposite of most kids. The answer maybe SNACKING. If you eat all the time, you have a high, constant histamine level. He’s hoping that eliminating snacking and taking DAO for meals will help.

In order to get a good idea of whats going on with these histamine issues, I read that it had to start with a healthy gut. It won’t be easy, but concentrate on what you eat in order to figure out the triggers. Right now I think my triggers involves too much milk. I just stopped eating yogurt, aged cheese, flavored coffees and sweetened coffee creamers. I stopped using vinegar and foods containing vinegar. Strawberries, cherries, cranberries, tomatoes, avocado I stopped eating them all after eating them so much. My allergist told me that I wasn’t allergic to anything. For years I have always eaten quite healthy. I don’t eat beef or pork so I’ve changed my diet from having too much of this, and not enough of that. This to can also be a problem. My triggers would cause me to have headaches which made me crave for coffee with cream even at night. Then by morning I would have a few hives. Not good, so I avoid this all together. I do have a prescription to use when needed, but I want to clean my gut first and concentrate on what my body is telling me. I guess Whole foods is the way to go

Hi, sorry to necro this thread, but have you tried olive oil and salt? Apparently olive oil is very high in DAO naturally, and salt can balance out high histamine against potassium. I have found that often a small sprinkle of salt in some olive oil can improve my breathing and calm me down when having a histamine attack. Would be interested to know what others find, as it’s much cheaper than rip-off DAO tablets! Also I agree that your gut needs to improve bacteria-wise as they are probably producing tons of histamine aswell. Polyphenols can help with or without probiotics. Thx and best of luck.